Surgical traction device



M; H. HERZMARK SURGICAL TRACTION DEVICE May 12, 1942.

Filed Aug. 13, r1940 7 INVENTOR. Hmzlwnk Patented May 12, 1942 k UITED STATES PATENT OFFICE SURGICAL TRACTION DEVICE Maurice H. Herzmark, New York, N. Y. Application August 13, 1940, Serial No. 352,354

5 Claims.

This invention relates to surgical apparatus, more particularly to a traction device which is adapted for the treatment of fractures.

It has been common practice for a great many years to treat fractures by means of traction devices which are intended to overcome the muscular contraction which automatically sets in in case of a fracture, the purpose being to hold the fractured bones in proper position until they are well knit together. Among the apparatus previously used was one consisting of a relatively large frame consisting of a number of members and devices whereby the length of the frame may be adjusted at will. On one end thereof was a memberadapted to be seated against the body of the patient and at the other end was a traction device which was intended to apply tension to the limb. Usually, such tension was obtained by weights attached to a cord or rope which was in turn attached to a stirrup or other device on the body of the patient. One such device included a drum or the like on which the rope was to be wound by means of a hand wheel and after the desired tension was obtained by winding, the hand wheel was held in place by a spring. The spring tension did not have any great effect and did not determine the amount of tension in the device. Furthermore, the apparatus was heavy, cumbersome and expensive.

It was uncomfortable, since the patient had great difficulty in moving, and also there was continuous pressure by the apparatus against the body. The tension was neither constant nor'could it be accurately predetermined. Slight movements of the patient would cause changes in the tension. Because of the bulky character of the device, the patient could not shift the position of his body, rendering it very painful to wear the device for any length of time.

Because devices of the above character immobilized the patient to his detriment, it has become customary to dispense with such a frame and to provide a tension device consisting of a considerable number of pulleys with a rope passing over the pulleys, one end of the rope being attached to the patient and the other end being attached to hanging weights. Because of the pulleys involved and the friction of the bearings thereof, the tension of the device was most un- A slight movement of the patient may reliable. change the angle of a rope or the rope may ride ofi of the pulley and become jammed between the pulley and the frame thereof. Such accidental displacement is usually not noticeable and it happened many times where a patient did not have the use of the device at all for long,

periods of time. Passers-by may accidentally knock off some of the weights and also because of the accessibility thereof, either the patient or a visitor may actually change the weight to accommodate the patient. Very often the weights become caught in the frame of the bed and the utility is lost for a period of time. Actual tests have shown that even though the rope and pulleys and weights were all in their proper position, the actual tension was from five to thirtyfive percent less than the weight placed in the device. Furthermore, the tension also changes whenever the bed is moved or when the linen on the bed is changed.

The present invention is intended and adapted to overcome the dimculties and disadvantages of the prior art and to provide a device which is simple, light and compact and which may be readily adjusted to any of a large number of types of bed.

It is also among the objects of the present invention to provide a traction device wherein the exact amount of tension desired may be placed upon the limb of the patient and such tension may be maintained regardless of the movements of the patient or changes in the position on the bed, or regardless of the disturbances about the bed.

In practicing the present invention, I provide an apparatus which has as its essential feature a reel wherein a strap or the like is wound on a drum which is held by a coiled spring. The spring has an excess of potential capacity so that it is wound only partly, the result being that in use even though the length of the strap which is attached to the patient may vary within wide limits, the tension produced by the spring on said strap during such variations remains substantially constant. There is also provided means whereby the tension of the spring may be adjusted to any desired amount of traction.

In the accompanying drawing, constituting a part hereof, and inwhich like reference charac ters indicate like parts,

Fig. 1 is a side elevational view of an apparatus made in accordance with the present invention;

Fig. 2 is a rear elevational view showing details of the construction of the standard;

Fig. 3 is an enlarged perspective view of the reel, some parts being broken away for clearness; and

Fig. 4 is a horizontal cross-sectional view through the reel taken along the line 4--4 of Fig. 1.

The standard I which may have an L-shaped cross-section is provided at its lower end with a bracket 2 having a flange 3 at the underneath side thereof and a set screw 4 passing through the flange whereby the same may be hooked onto a bed frame or bed spring and held in place by the screw 4. Along substantially the entire length of the standard I are suitably spaced keyhole slots having enlarged circular portions 5 and communicating therewith narrow rectangular portions 6. Locking guards I and I are provided with slots 8 and 8' adapted to be aligned with openings 6 and pivoted at 9 and 9', respectively, to standard I. Said guards have extensions l0 and 10' adapted to insure the holding thereof in their locked positions on the standard.

Horizontal slotted member I I has a depending flange I2, the latter having a pin I3 extending laterally therefrom and terminating in a head IS. The pin i3 is rectangular in cross-section and of slightly smaller dimensions than openings 6 so that it may fit therein. Openings 8 and 8' are slightly larger than said pin l3. Head I3 is of such size that it may be readily inserted into openings 5. Secured to slotted member H is a pair of depending fiat bars, usually covered with a rubber sheath, and intended to embrace the bars at the end of the ordinary hospital bed so as to constitute a brace to steady the whole device. A screw IS in member H extends through the slot (not shown) in member H and a wing nut I5 is threaded on the free end thereof to hold the brace in proper adjusted position anywhere along the slotted portion of member ll.

The reel comprises a casing I31 having a brace 18 of U-shape surrounding the casing and attached thereto by suitable screws I9. At one end of said brace there projects a rectangular pin 20 of a size corresponding with openings 6 and having a head 2| corresponding in size to openings 5.

Within the casing is a drum 22 having a flange 23 at one side thereof and mounted for rotation upon a shaft 24 held in the casing. One end of the shaft 25 is flattened and a lever 26 fitted onto the same, having at one end a knob 21 for rotation of the shaft by hand. At the opposite end of lever 26 is a pin 28 adapted to fit into any one of a series of openings 29 on the face of casing H. The combination of shaft, lever, pin and openings constitutes the equivalent of a pawl and ratchet arrangement for adjusting tension of the spring. A fiat spring 2| under lever 26 acts as a means for holding pin 28 in opening 29 against accidental displacement.

Within the drum 22 a fiat coiled spring 3| is placed, the inner end of the spring being attached at 32 to shaft 24 and the outer end of the spring being attached at 33 to the inside of the drum. A strap 34 is secured to the outer face of the drum at 35, is wound around the drum, and the free end thereof extends through an opening 36 in casing l1. As shown in Fig. 3, the edges of said opening are formed with turned-in portions in order to minimize friction between the strap 34 and casing IT. A ring 31 is secured by means of yoke 38 to the end of strap 34 and a swivel 39 is fitted onto ring 31. A clip 40 having a spring lock thereon is mounted in 39 for universal movement. Said clip is intended to be attached to the stirrup or other device on the patient in order to give traction to him.

In use, the clamp 3 is secured to the bed and brace H is placed thereon in the proper adjusted positions in order to firmly hold the device on the bed. The guard 1 or 1', as the case may be, is closed underneath head l3 to lock the brace l4 in position. Reel I1 is then placed in the proper position in an opening 5 with the strap 34 either above or below, as desired. Guard 1 is then closed in order to hold the reel in position.

Clip 40 is secured to the stirrup on the body of the patient and knob H is manipulated by Winding the same until the proper tension desired for the particular case is attained, and pin 28 is inserted in opening 29, being held there by the action of spring 30.

A device of this character has numerous advantages over the weight and pulley traction method which had previously been used. The tension may be accurately adjusted and is not subject to change by varying resistances of pulleys, wheels, ropes, or the like. There are no loose or swinging parts which are capable of being accidentally moved or even knocked off by passers-by. The present device is firmly secured to the bed and cannot be accidentally displaced. The device may be readily set up not only upon a hospital bed, but in the home as well without any diificulties. The device is self-contained, is small and compact, and requires no accessories whatsoever except a stirrup. Furthermore, it may be accurately adjusted by even an unskilled hand.

The traction in the present device is constant, partly because the spring is coiled to an extent which does not use up its entire potential energy or, in other words, is in an intermediate position of tension so that with considerable variations in the length of the strap, the traction does not change appreciably. Furthermore, the patient may be moved about, as when the bed is moved, linen is changed, or the bed is made, without affecting the traction. Because the traction obtained is constant, the patient is made more comfortable in that one may adjust his coverings without fear of displacing any of the traction device. At no time is there any strain on the patient and there are no parts of the device which produce pressure against him.

The device is adjustable very readily for different heights, positions of the patient, and limbs to be treated, and the reel may be placed in either vertical or horizontal position, thus affording a large variety of adjustments to fit the individual case. The device is of simple construction, is sturdy, and the parts are readily replaceable if repairs are necessary.

Although I have described my invention setting forth a single embodiment thereof, it is apparent that the invention is capable of various modifications within the spirit thereof. For instance, the device may be attached to a bed in any suitable manner and the attaching devices may be different from a mechanical standpoint than those described herein. It may also be attached to some other piece of furniture or may have a floor standard so that it is a self-contained unit. There may be provided a scale as part of the apparatus, either attached to the drum and spring or the strap 34, for showing the amount of tension applied. Also, markings may be made on the casing I! or some other part of the apparatus to show the amount of tension placed on the spring by the winding thereof through lever 26. Instead of the curled-in portions 36 of the casing, one may insert inside friction rollers, or such curled-in edges may be omitted if desired. Strap 34 is usually of woven fabric, but it may of course be of other suitable material, as for example a ribbon of steel or other metal. In place of a fiat drum 22, the same may be corrugated and a rope or cable may be wound thereon. Such strap, rope or the like may be made not only of any textile fibers desired, but also of artificial film-forming or plastic materials.

In place of the tension adjusting device shown,

other devices of similar character may be used, as for example there may be a ratchet on the drum and a pawl in the casing with a device such as a button on the casing for raising the pawl at the time it is desired to change the tension of the spring, or the pawl may be on the drum and the ratchet in the casing. Instead of the pin 20 being rectangular in cross-section, it may be made circular so that the reel I! may be adjusted not only in vertical or horizontal positions, but also in any desired intermediate positions. The present apparatus may be used in conjunction with other auxiliary devices for performing functions independent thereof. It is, of course, understood that the form of the various parts may be changed at will, certain of the elements described may be combined to form a lesser number of elements having the same functions, and one may substitute equivalent mechanical elements for individual elements shown and described herein.

These and other changes may be made within the spirit of the invention, the scope of which is not to be limited except by the character of the claims appended hereto.

What I claim is:

1. A surgical traction device for the treatment of fractures comprising a standard, clamping means thereon adapted to be fixed to a bed containing a patient and mounted to resist a horizontal force, a reel thereon, a spring in said reel, a strap having one end operatively connected to said spring and adapted to be extended out of said reel in a horizontal direction, said strap being unsupported in its entire length and having means at the free end thereof for attachment to the limb of a patient and exerting a substantial horizontal tension on said patient sufiicient to overcome muscular contraction, said tension being independent of gravity and against the weight of said patient, said spring freely biasing said strap to maintain a substantially con stant, predetermined, direct tension on said limb.

2. A surgical traction device for the treatment of fractures comprising a standard, clamping means thereon adapted to be fixed to a bed containing a patient and mounted to resist a horizontal force, a reel thereon, a spring in said reel, a strap having one end operatively connected to said spring and adapted to be extended out of said reel in a horizontal direction, said standard having means for mounting said reel in any one of a plurality of vertically spaced positions to allow said strap to extend horizontally, said strap being unsupported in its entire length and hav- 7 ing means at the free end thereof for attachment to the limb of a patient and exerting a substantial horizontal tension on said patient sulficient to overcome muscular contraction, said tension being independent of gravity and against the weight of said patient, said spring freely biasing said strap to maintain a substantialli constant, predetermined, direct tension on said limb.

3. A surgical traction device for the treatment of fractures comprising a standard, clamping means thereon adapted to be fixed to a bed containing a patient and mounted to resist a horizontal force, a reel thereon, a spring in said reel, a strap having one end operatively connected to said spring and adapted to be extended out of said reel in a horizontal direction, said strap being unsupported in its entire length and having means at the free end thereof for attachment to the limb of a patient and exerting a substantial horizontal tension on said patient sufficient to overcome muscular contraction, said tension being independent of gravity and against the weight of said patent, said spring freely biasing said strap, and means on said reel for adjusting the tension of said spring to maintain a substantially constant, predetermined, direct tension on said limb.

4. A surgical traction device for the treatment of fractures comprising a standard, clamping means thereon adapted to be fixed to a bed containing a patient and mounted to resist a hori zontal force, a reel thereon, a spring in said reel, a strap having one end operatively connected to said spring and adapted to be extended out of said reel in a horizontal direction, said strap being unsupported in its entire length and having means at the free end thereof for attachment to the limb of a patient and exerting a substantial horizontal tension on said patient sufiicient to overcome muscular contraction, said tension being independent of gravity and against the weight of said patient, said spring freely biasing said strap to maintain a substantially constant, predetermined, direct tension on said limb, said spring being in an intermediate position of tension so that the tension on said patient remains substantially constant upon movement of said patient in bed.

5. A surgical traction device for the treatment of fractures comprising a standard, clamping means thereon adapted to be fixed to a bed containing a patient and mounted to resist a horizontal force, a reel thereon, a spring in said reel, a strap having one end operatively connected to said spring andadapted to be extended out of said reel in a horizontal direction, said strap being unsupported in its entire length and having means at the free end thereof for attachment to the limb of a patient and exerting a substantial horizontal tension on said patient sufficient to overcome muscular contraction, said tension being independent of gravity and against the weight of said patient, said spring freely biasing said strap to maintain a substantially constant, predetermined, direct tension on said limb, said reel being mounted for oscillation on a horizontal axis.

MAURICE H. I-IERZMARK. 

